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Annual Medical Check-up in Group Health Insurance for Employees


Summary

annual health checkup

Group health insurance policy provides insurance protection to the employees of an organization enrolled under the same group health insurance policy. The medical checkup is a medical examination in the prospective applicant is required to undergo to provide an understanding to the insurance company regarding the acceptance of risk.

A pre-policy medical checkup is a medical examination that is mandated by the insurance company for the applicant to undergo before the acceptance of the health insurance proposal.

A pre-policy medical check up would require the applicant to undergo the listed medical tests in an empanelled hospital or diagnostic center of the insurance company, of which the reports would be shared directly with the insurance company to decide on the acceptance of the risk.

Group health insurance policies do not mandate for a pre-policy medical examination for the members of the policy before the issuance of the policy, whereas a retail health insurance policy would mandate for pre-policy medical checkup depending on the health condition declaration of the applicant.

An annual health checkup for employees is a medical examination provided by the insurance company for their group health insurance policy customers or the retail health insurance policy customers every year. Certain insurance companies provide free annual medical checkup if there are no claims in the previous year in case of retail health insurance policy.

Ethika Conducts Free Medical Check Up for Corporate Employees – Register Here

Group health insurance Annual Medical Check-up for Employees:

The annual medical checkup in the group health insurance policy is given to the members of the policy and their dependents (if covered under the group health insurance policy) for free once a year in any of the listed diagnostic centers or the empanelled hospitals of the insurance company. Group health insurance medical checkups are available for employees and their family members.

There are Insurance companies which provide free group medical annual check-up even for the members who availed a claim during the policy period. While some insurance companies provide free group health insurance medical checkups every alternate year, there are few companies which provide each year. For more details on the free group health insurance medical check-up please book a 15 minutes call with Ethika insurance to get an insight from the health insurance experts.

Below is the list of medical tests covered in the annual health check-up:-

  • Pre and post blood sugar levels test
  • Lipid profile test
  • Chest X-ray
  • Complete blood count
  • Urine test
  • Blood pressure test
  • ECG test
  • Liver function test
  • Vitamin deficiency test
  • Kidney function test etc.

Procedure to avail of free medical check-ups:

There would be a common question insurance broking companies face from customers:- Is medical checkup required for group health insurance? The answer for this is “NO”. It’s important to note that retail health insurance and group health insurance are quite different from each other. There is no medical checkup required for group health insurance policy. The procedure to avail the group health insurance medical check-up is mentioned below:-

  • At first you need to make sure that your group health insurance policy offers group medical annual check-ups for the members enrolled under the policy. You can contact your TPA or insurance company to understand the group health insurance medical checkup options available under the group health insurance policy.
  • The next step is to get in touch with the TPA or insurance company for an authorization letter which allows you to get a group medical annual check-up at any of the network hospitals for free. The facility can be availed by showing the authorisation letter from the insurance company.
  • The list of medical tests covered in annual health checkup can be found from the authorisation letter of the insurance company which mentions the eligibility of the group health insurance member.
  • You can also avail of the group health insurance medical checkup option by walking into any of the network hospitals or diagnostic centres of the insurance company and opting for a cashless facility.

Ethika Conducts Free Medical Check Up for Corporate Employees – Register Here

Benefits of Annual medical checkup:-

There are many benefits of availing of annual medical checkup under your group health insurance policy which are mentioned below:-

  • The members of the group health insurance policy would understand their health condition and help them in reducing the risk of potential health ailments and reduce the cost of hospitalization in the future.
  • For instance if a person is diagnosed with Cancer but is unaware of the same before the annual medical check-up, after the checkup he/she can approach the doctor for required treatment. If the diseases are acted upon in the early stages then there would be a good chance of recovery.
  • The reports would be analyzed by the doctors to understand your health and nip the diseases in bud if any.
  • The reports also help the insurance company in such a way that the medical costs incurred for treatment would be comparatively low. The cost of treating a disease in early stages is less and successful when compared to treating the disease in final stages.
  • The cost of group medical annual check-up would be borne by the insurance company as it would be less when compared to the treatment cost for the diseases in the final stages.

FAQs: There are certain FAQs on the group health insurance medical checkup which are answered below:-

What is a group health insurance medical checkup?

A group health insurance medical checkup is the medical examination provided by your group health insurance policy. The medical expenses are paid by the insurance company and the members of group health insurance policy can either avail cashless facility or reimbursement facility from the insurance company.

Is pre-policy medical checkup mandatory for group health insurance?

The pre-policy medical checkup is not mandatory for group health insurance policy. Pre-policy medical checkup would be mandatory only for retail health insurance policy depending on the declaration made by the applicant at the time of filling the proposal form.

Do we need to pay for a group medical annual check-up?

There is no need to pay for a group medical annual check-up under your group health insurance policy as the facility is provided free of cost by the insurance company. The cost of an annual medical checkup would be borne by the insurance company. Members of the group health insurance policy can avail the group medical annual check-up facility after getting an Authorization letter from the insurance company or through cashless mode.

The annual checkup expenses would be borne by the insurance company and paid directly to the network hospital or tie-up hospitals and the members can avail cashless facility.

What is the list of medical tests covered in the annual health checkup?

The list of medical tests covered in the annual health checkup are Blood pressure tests, Diabetic tests, Urine analysis, Lipid profile, chest X-ray, ECG, Liver function test etc.

Is it compulsory to avail group medical annual check-ups?

There is no compulsion to avail group medical annual check-up provided by the insurance company under the group health insurance policy. The annual check-up is provided as a complimentary service to the members of the group health insurance policy and it is upto the members to avail the facility.

In most of the group health insurance cases, less than 10% of the members avail the annual health checkup for employees during the policy period.

Ethika Conducts Free Medical Check Up for Corporate Employees – Register Here

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Susheel Agarwal

Namaste. I'm Abhinay Nedunuru, a Fellow of the Insurance Institute of India with a passion to make insurance simple and crisp. I write mostly on insurance and investment. I have a passion for teaching and training in particular to insurance. I'm currently doing my PhD from IIM in Marketing Management.